The proposed project will develop a new form of computer-assisted cognitive therapy for depression and will perform initial testing of this treatment approach. The proposal is submitted in response to PA-93-093 for Exploratory & Developmental Grants (R21) for Psychosocial Treatment Research The long-term objective o this investigation is to assess the effectiveness and cost reduction potential of a multimedia form of computer-assisted cognitive therapy (CCT) for depression If a computer program could decrease the amount o therapist time required to effectively treat major depression, more patients could benefit from psychotherapy. The proposed study will: (l) develop a method for CCT that will integrate the work of a clinician with a computer program; (2) develop and refine a treatment manual for CCT; (3) produce training materials for CCT and implement a training program in CCT for clinicians; (4) develop a measure of treatment adherence for CCT; (5) test the feasibility of CCT; (6) examine treatment outcome in CCT compared to standard cognitive therapy (CT) and a wart list control; and (7) pilot assessment procedures and determine effect size in order to provide necessary information for design of a full scale, randomized controlled trial. Phase I of the research program (months 1-6) will be devoted to therapy development. During this initial period, the investigators will refine therapy methods, train therapists, produce a treatment manual, and design and test a measure of therapist adherence for CCT. In Phase II of the proposed project (months 7-36), a preliminary randomized trial will be performed in which 45 subjects with major depression will be assigned to standard cognitive therapy (CT, n = 15), computer-assisted cognitive therapy (CCT, n = 15), or a wait list (WL, n =15) control group. Outcome measures will be administered before treatment and after four and eight weeks of the eight week treatment program. Outcome measures will be repeated three months after completion o therapy. Adherence of therapists to the CT and CCT treatment protocols will be assessed by external ratings of audiotaped therapy sessions. This study will be the &st randomized trial of a treatment method designed to combine the strengths o the clinician and a multimedia computer program m cognitive therapy for depression. The delivery of psychotherapy for depression could be influenced significantly if computer-assisted cognitive therapy is found to be an acceptable and effective treatment approach.